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Oklahoma rates for HCPCS L5624

Addition to lower extremity, test socket, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$249.63 / $249.63 / $249.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.62 / $249.63 / $285.29
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.54 / $494.54 / $494.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.38 / $509.45 / $509.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.77 / $311.77 / $311.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.60 / $311.77 / $325.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.54 / $349.44 / $2,310.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.13 / $287.66 / $568.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.13 / $262.33 / $328.00